Hospital-Acquired Infections Surged – And so did insurance premiums

Hospital-Acquired Infections Surged – And so did insurance premiums

By Greg Dattilo, CEBS

A dangerous side-effect of the COVID-19 pandemic includes a dramatic increase in the number of hospital-acquired infections.

Hospital-acquired infections happen when a person receives medical treatment in a hospital inpatient or outpatient facility. Recently, the Centers for Disease Control published a concerning report about a spike in hospital-acquired infections in 2020. This spike highly correlates with the 2020 major increase in hospitalization as a response to COVID-19.

“… ventilator-associated infections increased by 45% in the fourth quarter of 2020, compared to 2019.”[i] This, of course, would reflect the increased use of ventilators resulting from COVID-19 victims with extreme symptoms. The CDC reported that central line infections also increased by 46 percent during this time. Catheter-associated infections also spiked higher by double-digits.

It should not be a surprise, given the 2020 rash of the harried hospitalization of tens of thousands of quite ill individuals that the number of hospital-acquired infections would increase. This sudden demand on care does not excuse it, but helps explain it.

“If you break it, you fix it,” seems like a simplistic response to something as serious as life-threatening sepsis received at the hands of medical professionals. The sentiment, however, is quite universally accepted. If a person becomes infected during a hospital procedure or stay, the patient should expect the offending parties – the hospital system and its professionals – to provide medical care leading, hopefully, to a cure.

In The Manual – Healthcare 2020: Connecting the Dots,” we asked, “Who should pay to provide the patient’s medical treatment for a Hospital-acquired Infection?”[ii] The answer is that it, unfortunately, depends on who is paying for the patient’s medical care.

The reality is that if your insurance provider is a non-government, private entity, your insurance will pay the costs related to care from a hospital-acquired infection. In a perverse sense, this is a financial reward for contributing to your illness, rather than leading you closer to a cure.

Federal law, however, prohibits Medicare and Medicaid from, paying for the costs of treating a person who acquired an infection in a hospital. The federal law expects the provider to pay. When, however, the patient’s care is paid by a non-government health plan, the provider expects the insurance to pay them for the patient’s care. This has the effect of contributing to those increasingly unaffordable health insurance premiums.

There are two relatively simple fixes to these twin problems of infections and payment for care. First, make cleanliness and sterile operating centers a first priority – allow fewer infections. Two, “Require hospitals to absorb the cost by self-insuring for the care necessitated by their mistakes, just as is required by federal law for patients covered under a government health plan.”[iii]

Medical care of any type is not without risk. Patients, of course, hope that the facility and professionals treating them reduce those risks to as close to zero as possible. But when an infection happens, patients should expect providers to not only nurse them back to health, but do it at the provider’s expense.

At Dattilo Consulting, Inc., we continually monitor the factors that contribute to the high cost of health care. The Manual – Health Care 2020: Connecting the Dots, is an example of the research we provide on such factors. Contact us today to see how you might receive a free copy of “The Manual.”

[i] Morse, Susan (2021) COVID-19 Increased the Number of Healthcare Associated Infections. Healthcare Finance News. https://www.healthcarefinancenews.com/news/covid-19-increased-number-healthcare-associated-infections, accessed September 8, 2021.

[ii] Dattilo, G.; Racer, D. 92020) The Manual – Health Care 2020: Connecting the Dots. Alethos Press. St. Paul, MN. P 29.

[iii] Ibid. P 29.

Dave Racer
dgracer@comcast.net